The first major construction of the new Queen’s Medical Center West starts on Monday.

It’s a $73 million expansion and remodel of the old Hawaii Medical Center West.

From the outside, the former HMC West looks like a new building, but on the inside it’s a construction site.

Since last December, Queen’s Health Systems has been removing old equipment, upgrading wiring, and getting ready for a major remodeling project that will bring the new Queen’s Medical Center West into the 21st century.

“It really will be new… It’s really a brand new Queen’s Medical West Oahu. It will look and feel different than it ever did before,” Queen’s Medical West Chief Operating Officer Susan Murray said.

On Monday, major work will begin to expand the patient care center, emergency room, and operating room.

The demolition is set to being in the old emergency room. After it’s done, it will be three times larger with 23 beds.

Before the old HMC West closed, the emergency room was the second busiest in the state. Officials expect the same level of traffic when it opens.

The hospital will also share the same medical staff and technology systems with the Queen’s Medical Center in Honolulu.

“If you do an X-ray out here or you get a sound wave study of your heart out here, it can be sent to our central campus where we can read things, get things done appropriately. And our turn-around time should optimize patient care,” Queen’s Medical Center Chief of Staff Dr. Robert Hong said.

The new hospital is expected to open in the spring of 2014 and will employ up to 400 new workers.